For the past year, I have had concerns about what was going to happen as my health insurance carrier, as a side effect of the Affordable Care Act (ACA), was no longer going to carry medical insurance as of January 1, 2014. This meant that I would have to find new insurance. With my medical conditions, this had me worried. Would I be able to find insurance that would still cover me when I see my doctor at Mayo Clinic? Would I have coverage for my medication that is required to keep me healthy? I decided that since I could do nothing about the situation (as in, I cannot single handedly change the law, make all of the politicians play nice, etc.), I would wait it out and see what would happen. On October 1, 2013, the Affordable Care Act was to go into effect in the United States of America, but due to political differences by members of Congress, the United States federal government was shutdown. I am not an expert in politics, in human medicine, or really in anything. I am a person with reasoning skills, education, faith, and compassion. This got me to thinking about health care in the United States of America. What does this mean?
If I break down the phrase “health care in the United States of America,” I get three separate topics – health, care, and United States of America.
If you ask most people in the USA, you would get many definitions for the word health, ranging from lack of illness to physically thriving to well being of the body. In 1946, the World Health Organization (WHO) stated that health is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” I am not aware of anyone that is in a state of health that meets this definition, at least not for an extended period of time. It would be wonderful! In the USA, we are lucky to have vaccinations and medications that allow us to reach a better physical health, but we unfortunately also have more processed foods and busy lives that act as a barrier to having true physical, mental, and social well-being. How many people lament the time that they spend away from their family and friends due to work, that don’t get a vacation to unwind, or that have to work two or three jobs to provide food for the children that they never see? How many parents spend their work day worried about their child, but then are worrying about work when they take time off to be with that child? We, as a whole, worry about what we cannot control. It is difficult to not focus on the would haves and could have situations instead of the what is and what are realities.
We live in a culture that nutrition is generally available so that a “mild” illness generally is not life threatening like it is to a child that is also suffering from dehydration, intestinal parasites, and starvation. We have many advantages, the unfortunate part is that much of that medicine is often out of the reach of people. The preventative medicine that can help keep us healthy is ignored due to cost, so it is not until someone is so ill that there is nothing else to do that they end up in the emergency room. Due to the costs of medical care, the family may end up in bankruptcy, losing their home, or many other scenarios. I have been blessed in the fact that I have always had insurance, yet, I have still paid between $8,000-10,000 per year for my medical expenses for the last 5-6 years – this does not include insurance premiums. Luckily, I knew (after the first year) that I would have these expenses and we have saved to be able to afford them. I am blessed to have a job where that is possible, even though we cannot live extravagantly, in fact, we live quite frugally. The cost of maintaining health is high in the USA. Then there are the other preventative aspects of health – exercise, diet, emotional/psychological well being, and positive interactions with those around you.
Care has many definitions as well, but it boils down to respecting and providing for needs. When you care for a person (or an animal), you want what is best for them. You encourage and support them. To me it indicates that there is a relationship and a bond present. In the context of health care it means the treatment and management of illness, and the preservation of health through services offered. This definition (from Wikipedia), does not leave room for a relationship, it is very clinical and even distant. This makes me sad. When an individual or family walks into my exam room with their pet, I strive to build a relationship of trust and mutual respect. That is how I can provide the best care for my patients. When medicine becomes cookbook – everyone is treated exactly the same way, then there are going to be some that “fall through the cracks.” A single medication may not be the answer. Sometimes the answer is a combination of medications and diagnostics or treatments, but if I don’t listen and truly hear the problem or the situation in the home, then I will make mistakes. Paying attention to the lives of the people allows a better decision to be made. In a situation where a patient needs medication 3 times a day, but the primary caregiver works 15 hours a day is not going to work. A different medication may be needed or working with the primary care giver to find other alternatives are imperative. I have had doctors that have ignored what I have told them or perhaps just didn’t know what to do with the information I have given to them. If it was not for my own knowledge and recognition that the doctor did not meet my needs, I would not have ended up receiving the care that I now have. Without my knowledge and the knowledge of other people, I may have accepted the doctor’s word that I was fine and there was nothing to worry about. This doctor did not provide care. I had to be my own advocate and care enough about myself to seek a new doctor. If you get nothing else out of this blog today, please take away that you are your own advocate! There are people that can help, but if you do not receive the care that you need and deserve, find a new doctor, veterinarian, minister, or even congress person. You, and everyone else, deserves to be cared for with respect.
The USA is a federal republic, which means that it is a division of power between the states and the national government. It is also a representative democracy, which means that all eligible citizens can partake equally through elected representatives, rather than as an individual vote or rule. I have always been happy to part of the USA, the ability to believe what I want to believe, to not be persecuted (on a governmental level) for those beliefs, and to have access to a better life than what others before me may have had, to be able to follow my dreams. This has not been free, but it has been available to me. For many, even being in the USA has not provided the same blessings and gifts. For many the cycle of poverty, abuse, and addiction stops them from moving forward. Some are able to claw out of the pits of despair, but others are swallowed. There are other people that get caught in a cycle of “keeping up with the Joneses” or believe that they are better than someone else. This is just as damaging to our nation as poverty. The recent events with the government shutdown have damaged this concept of UNITED States of America. There is fractioning and splintering of our nation. There is extreme polarization of political, social, economic, and religious values. I do not see people coming together for the greater good of our nation and its people. We do not have to agree on all of the details, but we, as a nation, need to learn to get along. Why is it that you can put young children into a room and they can play regardless of race, color, or creed, but as the children are exposed to adults, they begin to learn hate and distrust of others? Why do we, as adults, continue bigotry, hate, and repression of others to make ourselves feel good? This makes no sense to me.
When we put all three terms together again Health Care in the United States of America, I hope and pray that we will have it some day. That we will have health and wellness, that everyone will care for one another, that we will be united again. I don’t know what will happen with my health insurance situation, but I do know that there are many people that did not have any coverage that hopefully will now. That preventative care will take over from only emergency care. That people will hold our elected representatives and all that are there to care for us responsible for their actions or inactions. I don’t have the answers, but I do know that if we work together in all things, we will prevail, we will succeed, we will CARE!
I ask that each of you meet with someone that has views that differ from your own. Sit down to really talk and learn from each other. You may learn that you believe in the same things, but have a different solution or ideal in mind. You may learn that you are not that different after all. Take the time to care for that person, and hopefully they will do the same for you. One person at a time. One day at a time, we can make a difference!